Obertová Zuzana, Scott Nina, Brown Charis, Stewart Alistair, Lawrenson Ross
Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
BJU Int. 2015 Apr;115 Suppl 5:24-30. doi: 10.1111/bju.12900.
To examine temporal trends and current survival differences between Māori and non-Māori men with prostate cancer in New Zealand (NZ).
A cohort of 37,529 men aged ≥ 40 years diagnosed with prostate cancer between 1996 and 2010 was identified from the New Zealand Cancer Registry and followed until 25 May 2011. Cause of death was obtained from the Mortality Collection by data linkage. Survival for Māori compared with non-Māori men was estimated using the Kaplan-Meier method, and Cox proportional hazard regression models, adjusted for age, year of diagnosis, socioeconomic deprivation and rural/urban residence.
The probability of surviving was significantly lower for Māori compared with non-Māori men at 1, 5 and 10 years after diagnosis. Māori men were more likely to die from any cause [adjusted hazard ratio (aHR) 1.84, 95% confidence interval (CI) 1.72-1.97] and from prostate cancer (aHR 1.94, 95% CI 1.76- 2.14). The aHR of prostate cancer death for Māori men diagnosed with regional extent was 2.62-fold (95% CI 1.60-4.31) compared with non-Māori men. The survival gap between Māori and non-Māori men has not changed throughout the study period.
Māori men had significantly poorer survival than non-Māori, particularly when diagnosed with regional prostate cancer. Despite improvements in survival for all men diagnosed after 2000, the survival gap between Māori and non-Māori men has not been reduced with time. Differences in prostate cancer detection and management, partly driven by higher socioeconomic deprivation in Māori men, were identified as the most likely contributors to ethnic survival disparities in NZ.
研究新西兰（NZ）患前列腺癌的毛利族和非毛利族男性的时间趋势及当前的生存差异。
从新西兰癌症登记处识别出1996年至2010年间确诊患前列腺癌的37529名年龄≥40岁的男性队列，并随访至2011年5月25日。通过数据链接从死亡率数据库获取死亡原因。使用Kaplan-Meier方法以及经年龄、诊断年份、社会经济剥夺程度和城乡居住情况调整的Cox比例风险回归模型，估计毛利族男性与非毛利族男性的生存率。
确诊后1年、5年和10年，毛利族男性的生存概率显著低于非毛利族男性。毛利族男性更易死于任何原因[调整后风险比（aHR）1.84，95%置信区间（CI）1.72 - 1.97]以及死于前列腺癌（aHR 1.94，95% CI 1.76 - 2.14）。与非毛利族男性相比，诊断为局部扩散的毛利族男性前列腺癌死亡的aHR为2.62倍（95% CI 1.60 - 4.31）。在整个研究期间，毛利族和非毛利族男性之间的生存差距未发生变化。
毛利族男性的生存率显著低于非毛利族男性，尤其是在诊断为局部前列腺癌时。尽管2000年后确诊的所有男性的生存率有所提高，但毛利族和非毛利族男性之间的生存差距并未随时间缩小。前列腺癌检测和治疗方面的差异，部分由毛利族男性较高的社会经济剥夺程度所驱动，被确定为新西兰种族生存差异的最可能原因。
